Added on November 13, 2009A few more remarks on US health
care reform: Why should employers provide health care for their employees?
That is an individual decision. In Germany, you can see that it can become a
problem when rising health care costs and wages are coupled, especially in
an aging population. - Medicare and Medicaid are already entitlement
programs. You cannot touch them without making voters angry. Will a public
option increase competition and lower prices? Anything public is taxpayer
funded or it is not public. Have you never heard of Medicare and Medicaid,
of Fannie Mae and Freddie Mac, in short: of black holes? - According to the
House Bill, small businesses with annual payrolls less than $500,000 would
be exempt from providing health care to their employees. Employers with
payrolls between $500,000 and $750,000 would have to pay a 2%-6% tax,
employers with a payroll above $750,000 would have to pay an 8% insurance
tax for their employees. Not very promising for them. - The insurance-market
reform goes in the right direction. What we need around the globe are real
markets for drugs, insurances, doctors and hospitals, not micromanagement as
proposed in the 1990-page bill, which would backfire if implemented. - The
current system has to be reformed. The GOP's main objective seems to be to
sabotage the reform without coming forward with a substantial
counterproposal. The welfare state is not the solution. Inaction either. The
new German coalition is currently trying to reform its health care system
too by introducing more market elements. Who will come up with the better
system?

Article added on November 8, 2009 Late on Saturday November 7, the United States House of
Representatives, the lower house of the bicameral U.S. Congress, has passed the
most important health care reform since the
creation of Medicare insurance program for the elderly in 1965. 220 members
of the House voted for the bill, 215 against it.

However, the House has just passed its version of the 1990-pages bill. The Senate will have its say too.
In the end, both houses of Congress will have to agree on the final version.
Save your cheers or boos for later.

The 1990-pages
Affordable Health Care for America Act
is just
another bureaucratic monster like the
“Stimulus Bill”. Among us, if Obama wants another “stimulus”, he should turn
to Michelle. And no, we don't want to know any details about it.

According to estimates by the Congressional Budget Office, the
Affordable Health Care for America Act in the form passed by the House would
enlarge health insurance to about 96% of legal residents in the United
States, up from only 83% now. Some additional 36 million Americans would be
covered. The bill also covers
the
“doughnut hole”.

The health care overhaul is unfortunately not only a step in the right
direction. Private insurers would have to compete with public insurance
plans. Another subsidized option will not make health care cheaper. The
additional cost is estimated at about $1 trillion over a decade. Of course,
no one knows how much it will really cost. Republicans are right that it is
a step towards a European welfare state.

At the same time, the Affordable Health Care for America Act calls for
several hundred billions of dollars in cuts to Medicare. The cuts are aimed
at eliminating Medicare's wasteful spending. It could end up eliminating
Obama's support by the elderly who are worried that their health care
coverage is in danger. What is certainly in danger is the aim of a balanced
budget.

The Affordable Health Care for America Act levies a 5.4% tax on individuals
earning more than $500.000 a year as well as couples earning over $1 million
a year. All but the smallest employers would be forced to provide health
insurance to their employees and pay for most of the premium, otherwise they
could be fined up to 8% of their payroll.

Health care coverage to everyone regardless of pre-existing conditions is
surely a must in any decent society. However, anything socialized is not
working. You have to push the private companies to compete with each other.
The present bill does not avoid public options; incidentally, Medicare for
the elderly and Medicaid the poor are already at least partly public
programs.

The new bill does not tackle the malpractice system, the problem of lawsuit
abuse which pushes health care costs up. Trial and injury lawyers perverted
consumer protection. Doctors try to protect themselves by ordering costly
and time consuming additional tests before helping patients.

Charles Krauthammer argued in a Spiegel interview:
“It is absolutely crazy that in America employees receive
health insurance from their employers -- and at the same
time a tax break for this from the federal government.
It's a $250 billion a year loophole in the government's
budget. If you taxed healthcare benefits, you would have
enough revenue for the government to give back to the
individual to purchase their own insurance. If you did
those two reforms alone, you would have the basis for
affordable health insurance in America.”
Maybe something to consider.

The Democratic Speaker Nancy Pelosi scored a victory by passing her
president's health care overhaul. But she had to compromise. Last but not
least, an anti-abortion amendment was passed. It was primarily sponsored by
her fellow Democrat Representative Bart Stupak from Michigan, who lead a
group of 40 anti-abortion Democrats who could not be ignored.

The Republican House Minority Whip Eric Cantor had promised at a
“Tea Party” on November 5 that no Republican would vote for the health care
bill. It turned out differently. There was one dissenting voice: Anh
“Joseph” Cao from Louisiana voted for the bill.

The Vietnamese-born Republican who came to the U.S. at the age of eight is a
freshman who won a special election in December 2008 in a 60% black and 60%
Democratic district against an incumbent Democrat who had been found guilty
in August 2008 of 11 out of 16 criminal counts including bribery, money
laundering and racketeering. Rep. William J. Jefferson had also hidden
$90,000 in cash in his freezer.

On November 8, before the health care vote, Anh
“Joseph” Cao, a former Catholic seminarian and ethics teacher, had supported a
successfully passed health care amendment from Democratic Rep. Bart Stupak
prohibiting federal money from funding abortion. For the Catholic Cao, the
adoption of this important amendment was good enough an improvement of the
health care bill for him to vote for it.

Cao posted the following statement on his website:
“My vote tonight was based on my priority of ding what is best for my
constituents.” In fact, Cao represents a largely poor district with plenty
of people who would profit from the new bill.

With or without the yes by Cao, the bill would have past the House, despite
the 39 Democrats who refused to support the
Affordable Health Care for America Act. Is Cao's vote
the end of the rise of his young star or on the contrary enhances his voter
attractiveness?

The health care overhaul as another nail in the budget coffin

The famous
“Stimulus Bill” so far has mostly stimulated and satisfied the Democrats
appetite for their pet projects, but not the economy. As presidential
candidate and as president, Barack Obama has repeatedly stressed that job
creation was his priority. On November 6, the Bureau of Labor Statistics
released the official unemployment figures for October 2009: 10.2%. In
October 2008, the rate was only 6.5% [2008 number corrected on November 8,
2009 at 16:30 German time]. In October 2009, the underemployment rate - including
part-time worker looking for full-time jobs as well as those who have
stopped looking for a job - has even reached 17.5%. Mission not
accomplished, Mister President! Anyway, it is not up to the president to
create jobs. He just has to set the general framework (Rahmenbedingungen).

However, Fannie Mae and Freddie Mac as well as Citigroup and Bank of
America have not been broken up into smaller entities. They remain too big
to fail and are still losing money. In Iraq and
Afghanistan,
the United States are still losing both, soldiers and money. Bold action is
required. More soldiers and money in the short term in order to turn it
definitively around within one to two years, requiring substantially less
subsequently. What America got in the first year of the Obama presidency was
definitely not “change you can believe in”.

Now Congress is about to add another financial liability to the neck of
(mainly future) American taxpayers, the health care reform. Let's hope that
together with the Senate, the House of Representatives will rethink its
health care overhaul and make it better and less expensive thanks to a real
health care market including doctors, hospitals, drug and insurance
companies competing for customers. State intervention and subsidies are not the solution. Skip the public option, but make
health care universal without repeating Europe's mistakes.

President Obama visited his Democratic House lawmakers before the vote and
told them according to Teddy Davis of ABC News:
“Do any of you expect the Republicans not to go after you if you vote against
this bill?” He forgot to mention that the problem are not the fellow
Republican lawmakers, but the voters the Democrats will have to face one
day. The bill in its present version does not tackle the problem of soaring
health care costs. It is one additional nail in the U.S. budget coffin.
Obama may have won a Pyrrhic victory. The President, the Senate and the
House still have time to fix it.